Bowel Disease in Babies

Bowel disease in babies is known by its medical term as Hirschsprung's disease. The disease affects the bowel or large colon by causing problems passing stools. The problem is caused by the inability of the bowel muscle to function properly. Most cases are diagnosed at birth, but some people may not experience symptoms until later in childhood or adulthood.

Causes

• Muscle contractions within the bowel help move digested foods through the intestine. Nerve cell groups within the bowel called ganglia trigger these contractions. Babies with bowel disease have sections of the colon missing these nerve cell groups, causing the inability of stool to be pushed out. No reason has been found for why these nerve cell groups do not form. Children with Down syndrome are 10 times more likely to have Hirschsprung's disease, according to the Mayo Clinic.

Symptoms

• Symptoms of bowel disease in babies include failing to pass stool in the first or second day after being born, watery diarrhea, gas and vomiting a green liquid, which is a bile produced by the liver.

Diagnosis

• An X-ray using a contrast dye enema may be used to diagnose Hirschsprung's disease. A dye liquid called Gastrografin or Hypaque is normally used on newborns and may help move the first stool through because the dye draws water to the intestine, softening the stool. The contrast dye lines the colon and creates an image of the intestine and rectum. Areas where nerve cell groups are missing will appear narrower. A biopsy of colon tissue will also reveal if the nerve cell groups are missing.

Treatment

• Hirschsprung's disease is treated with a surgical procedure called a pull-through operation. This surgery involves removing the section of colon that does not contain nerve cell groups and reconnecting the rectum to the healthy colon. The procedure may be performed in two parts to allow the colon to heal before reconnection. The surgeon will create a hole called a stoma in the newborn's stomach and connect the healthy colon to the hole. A bag is attached to the stoma and stool is passed into the bag which will need to be emptied several times a day. This allows the lower intestine time to heal and the surgeon will then close the stoma, reconnecting the healthy colon and rectum. The procedure is called an ileostomy if the entire large colon is removed and a colostomy if only a portion of the large intestine is removed.

Considerations

• Children should start passing stool normally after surgery, but diarrhea may occur first. Toilet training may take longer because of coordinating the muscles to pass stool. A baby may run the risk of developing enterocolitis in the small intestine or in a portion of the large colon after surgery. Symptoms may include fever, vomiting, diarrhea, swollen stomach and bleeding from the rectum. Contact your doctor immediately if these symptoms appear.